Postoperative Delirium After Dexmedetomidine versus Propofol Sedation in Older Adults Undergoing Hip Fracture Surgery with Spinal Anesthesia: A Randomized Controlled Trial.

Study Summary

834 patients aged 65–90 years undergoing hip fracture repair under spinal anaesthesia with a fascia iliaca block were randomized to receive intraoperative sedation with dexmedetomidine or propofol. The primary outcome was postoperative delirium within 72 hours, assessed twice daily using the Confusion Assessment Method. Secondary outcomes included postoperative pain through day 3, intraoperative haemodynamic events requiring treatment, length of hospital stay, other postoperative complications, and 30-day mortality. Overall, delirium was less frequent with dexmedetomidine, with no significant differences in pain or haemodynamic events requiring treatment. These findings suggested that sedative choice could reduce early postoperative delirium in older adults undergoing hip fracture repair with this regional anaesthetic regimen.